POS0901 CAN B-MODE OCULAR ULTRASOUND ASSESS VITRITIS IN PATIENTS WITH AXIALSPONDYLOARTHRITIS AND PSORIASIC ARTHRITIS?
Authors: J. A. Mendonça, L. Eduardo Pedri, F. Andrade, L. Biselli, L. B. Nucci
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Vitritis is the presence of cellular infiltration in the vitreous body, resulting from inflammation of the vitreous cavity itself or from the extension of the anterior chamber inflammatory process<sup><b>[1</b>]</sup>. Uveitis is the most frequent extra-articular manifestation of axial spondyloarthritis and psoriatic arthritis, and may occur in any uveal topography<sup><b>[2</b>]</sup>. B-mode ultrasound can useful for confirming uveitis, especially in those conditions in which there is opacification of the light-conducting medium and the vitreous cavity and the rest of the globe cannot be visualized by ophthalmological examination<sup><b>[3</b>]</sup>. In the case of vitritis, the vitreous appears on the ultrasound screen in the form of thin, confluent and mobile images<sup><b>[4</b>]</sup>. <h3>Objectives</h3> To detect the presence of vitritis in patients with axial spondyloarthritis and psoriatic arthritis using a B-mode ocular ultrasound and comparing it with the slit lamp ophthalmologic examination. <h3>Methods</h3> Observational and cross-sectional study with 6 patients with non-radiographic axial spondyloarthritis according to the ASAS criteria; 24 with radiographic axial spondyloarthritis according to the modified New York criteria and 34 with psoriatic arthritis according to the CASPAR criteria, selected for convenience between the months of August and December 2021, from the Rheumatology outpatient clinic of the Pontifical Catholic University of Campinas Hospital. One hundred and twenty-six eyes were evaluated by an ophthalmologistby slit lamp biomicroscopy. B-mode ocular ultrasound machine (EsaoteSpA, São Paulo, Brazil) was performed with a high frequency linear probe of 12MHz. A total of 127 eyes were evaluated, categorizing vitritis semi-quantitatively through the intensity of echovitreous in grades 0 (absent), 1 (mild), 2 (moderate) and 3 (severe) <b>(Figure 1</b>). Sensitivity, specificity, negative (NPV) and positive (PPV) predictive values and the ROC curve were calculated for B-mode ultrasound in relation to the ophthalmological evaluation. <h3>Results</h3> The mean age of patients with axial spondyloarthritis was 46.3±13 years, with a BASDAI of 4.10±2.84. The mean age among patients with psoriatic arthritis was 55.2±12.5 years, with a DAPSA of 24.27±22.15. Ophthalmic examination detected vitritis in 3.33% of the eyes. B-mode ultrasound identified grade 0 echovitreous in 39.37% of the eyes, <b>grade 1</b> in 25.98%, <b>grade 2</b> in 29.92%, and <b>grade 3</b> in 4.73% of the eyes. Sensitivity, specificity, NPV and PPV are described in <b>Table 1</b>. The ROC curve: area under the curve of <b>0.58 (95% CI: 0.41-0.74</b>). <h3>Conclusion</h3> B-mode ocular ultrasound showed an excellent negative predictive value for detecting vitritis, constituting an important complementary tool in the evaluation of uveitis in patients with axial spondyloarthritis and psoriatic arthritis. <h3>References</h3> [1]Touhami S, Leclercq M, Stanescu-Segall D, et al. Differential Diagnosis of Vitritis in Adult Patients. Ocul Immunol Inflamm 2021;29:786–95. [2]Rosenbaum JT. Uveitis in spondyloarthritis including psoriatic arthritis, ankylosing spondylitis, and inflammatory bowel disease. Clin Rheumatol 2015;34:999–1002. [3]Mendonça JA. B-mode ultrasound in the uveitis in the psoriatic arthritis without skin lesion. Int J Clin Rheumtol 2020;15:64–6. [4]Mendonça JA. Ultrasonographic Follow-up of Uveitis and Arthritis with Golimumab in a Patient with Peripheral Spondyloarthritis: Case Report. J Clin Med Img Case Rep. 2022; 2(1): 1064. <h3>Acknowledgements</h3> To all the patients and the entire group that participated in this study. <h3>Disclosure of Interests</h3> José Alexandre Mendonça Speakers bureau: Novartis; Janssem and AbbVie., Paid instructor for: Novartis; Janssem and AbbVie., Consultant of: Novartis; Janssem and AbbVie., Lucas Eduardo Pedri: None declared, Flávia Andrade: None declared, Livia Biselli: None declared, Luciana B Nucci: None declared.